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General NPI Number Information
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NPI Number | 1508720863
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Entity Type | Organization
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Legal Business Name | 4610 PSYCHOTHERAPY SERVICES, INC.
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Dates
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Enumeration Date | 12/11/2025
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 13130 ROSE ST
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City | CERRITOS
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State | CA
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Zip | 90703
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Country | US
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Telephone | 714-595-7871
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Fax |
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Provider Business Mailing Address
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Address Line | 11331 183RD ST # 179
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City | CERRITOS
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State | CA
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Zip | 90703-5434
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Country | US
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Telephone | 714-595-7871
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Fax |
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Authorized Official
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Title or Position | OWNER/ MARRIAGE FAMILY THERAPIST
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Name | CONSTANCE E. SHIN
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Credential | LMFT
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Telephone | 714-595-7871
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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